Baseline findings of a randomized feasibility trial of lung cancer screening with spiral CT scan vs chest radiograph - The Lung Screening Study of the National Cancer Institute
Baseline findings of a randomized feasibility trial of lung cancer screening with spiral CT scan vs chest radiograph - The Lung Screening Study of the National Cancer Institute
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DOI：
10.1378/chest.126.1.114
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发表时间：
2004-07-01
期刊：
影响因子：
9.6
通讯作者：
Prorok, P
中科院分区：
文献类型：
--
作者：
Gohagan, J;Marcus, P;Prorok, P
背景：低辐射剂量螺旋CT（LDCT）扫描能够检测无症状个体的肺部肿瘤。为了确定这种检测是否可以降低肺癌死亡率，需要进行 LDCT 扫描的随机对照试验 (RCT)。 方法：肺部筛查研究 (LSS) 探讨了在肺癌高危人群中进行随机对照试验 (RCT) 的可行性，该研究是正在进行的前列腺癌、肺癌、结直肠癌和卵巢癌 (PLCO) 癌症筛查试验的一个为期 12 个月的特别项目。 2000 年秋季，六个 PLCO 筛查中心总共招募了 3,318 名未参加 PLCO 试验的重度或长期吸烟者，并将他们随机分配接受筛查 LDCT 扫描（1,660 名参与者）或筛查后前位胸部 X 光片 (CXR) [1,658 名参与者]。 结果：LDCT 扫描组中 96% 的受试者和 93% 的受试者中完成了筛查。 CXR 臂。 LDCT 扫描组中总共 20.5% 的筛查受试者和 CXR 组中 9.8% 的筛查受试者有疑似肺癌的发现。 LDCT 组中的 30 例肺癌患者和 CXR 组中的 7 例患者在筛查结果呈阳性后被诊断出患有肺癌。 LSS 的其他数据表明，在肺癌风险较高的人群中，CT 扫描的使用并不普遍，参与 LDCT 扫描的 RCT 的兴趣很强烈，很少有随机接受 CXR 的受试者拒绝检查或在 CXR 研究后寻求 CT 扫描。 解释：LSS 的结果令人信服地证明了在美国进行 LDCT 扫描的 RCT 的可行性。
Background: Low-radiation-dose spiral CT (LDCT) scanning is capable of detecting lung neoplasms in asymptomatic individuals. To determine whether such detection can reduce lung cancer mortality, a randomized controlled trial (RCT) of LDCT scanning is necessary.Methods: The feasibility of conducting an RCT in asymptomatic individuals who are at high risk for lung cancer was explored in the Lung Screening Study (LSS), a 12-month special project of the ongoing Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial. During the fall of 2000, six PLCO screening centers recruited a total of 3,318 heavy or long-term smokers who were not participants in the PLCO trial and randomized them to receive either a screening LDCT scan (1,660 participants) or screening posteroanterior view chest radiograph (CXR) [1,658 participants].Results: The screens were completed on 96% of subjects in the LDCT scan arm and 93% of subjects in the CXR arm. A total of 20.5% of screened subjects in the LDCT scan arm and 9.8% of those in the CXR arm had findings that were suspicious for lung cancer. Thirty lung cancers in subjects in the LDCT arm and 7 lung cancers in patients in the CXR arm were diagnosed following a positive screening result. Additional data from the LSS indicated that, among persons who were at elevated risk for lung cancer, CT scan use was not pervasive, interest in participating in an RCT of LDCT scanning was strong, and few subjects randomized to CXR either refused their examination or sought a CT scan after their study CXR.Interpretation: The results of the LSS demonstrated convincingly the feasibility of an RCT of LDCT scanning in the United States.